Hangxiety: The Link Between Anxiety and Alcohol

Drink long enough —
or hard enough — and you’re probably familiar with the dreadful feeling that
comes the morning after a night of over-imbibing. Maybe you try to replay the evening’s
conversations in your mind or scroll through text messages to make sure you
didn’t send something you regret. Or maybe you immediately start issuing mass apologies
to friends and family.

While this can be a normal reaction to binge drinking, it can also be a sign of a deeper issue, something called “hangxiety.”

“Anxiety is a common feeling when people drink too much,” says Elizabeth Bulat, M.D., a substance abuse specialist at Henry Ford Health System. “And for people who are already prone to depression and anxiety, alcohol can worsen symptoms of those conditions.”

Hangxiety Explained

Hangxiety has become
a buzzword that describes the uneasy feeling that often accompanies heavy
alcohol use, but what does it really mean? We asked Dr. Bulat to explain what
hangxiety is and how to manage it best.

Q: What
is hangxiety?

A: Drinking alcohol dumps a flood
of dopamine into the pleasure center of the brain. The feel-good chemical swirls
through your head, but the rush only lasts for a short while. When dopamine
levels dip back down, feelings of anxiety rebound. Researchers
think that may be one reason why people who experience hangxiety, especially
those who are extremely shy, may have a higher risk of developing alcohol use
disorder (AUD).

Q: How
does alcohol boost anxiety levels?

A: Heavy drinking produces
physiological changes in the brain. When you’re drinking, there’s an influx of
the GABA (gamma aminobutyric acid), which causes you to feel relaxed and calm.
When you stop drinking, you have withdrawal symptoms. Your body gets used to
that crutch to feel calm. Take it away and anxiety often follows. Add
interrupted sleep to the mix, which often happens when people drink to excess,
and feelings of depression and anxiety can get even worse.

Q: Who
is most likely to develop hangxiety?

A: People who suffer from depression and anxiety are more likely to
experience anxious feelings after drinking. Though alcohol can suppress anxious
feelings while a person is imbibing, the rebound effect can be far worse than
their baseline level of anxiety. Unfortunately, those uncomfortable emotions
can drive people straight back to the culprit: alcohol.

Q: How
does alcohol compare to medications used to treat anxiety?

A: Like alcohol, medications such
as benzodiazepines that are used to treat anxiety target GABA in the brain. In
fact, some people with depression and anxiety turn to alcohol to self-medicate.
Unfortunately, self-medicating with alcohol or other substances increases the
risk of developing substance abuse disorders, which can lead to negative
effects on your heart, liver and other vital organs.

Q: How
do you know if your hangxiety indicates an alcohol use disorder, or AUD?

A: If you’re using alcohol to soothe anxiety, that’s a red flag. It becomes a vicious cycle: You drink, you get anxious, then you drink more to relieve that anxiety. That’s how the trouble starts — and continues. Over time, you become dependent on the alcohol to function in your daily life. If alcohol becomes a coping mechanism, or you realize your body is getting used to the effects — not just anxiety, but also shakes, sweats and interrupted sleep — the risk of negative consequences skyrockets.

Q: How
do doctors treat hangxiety?

A: If you’re drinking to manage
feelings of anxiety — or if you regularly experience hangxiety after a
night of drinking — talk to your primary care provider. There are a number
of effective treatments available, not just for depression and anxiety, but
also for AUD. Your doctor may suggest a variety of therapies ranging from
cognitive behavioral therapy and psychotherapy to prescription medication for
AUD or anxiety.

Put Hangxiety to Bed

Your best bet to
avoid hangxiety is to drink responsibly, says Dr. Bulat. Pay attention to
family members and loved ones who say they notice an increase in your drinking
habits and stay within the recommended limits of alcohol consumption (one drink
per day for women; two drinks per day for men).

If, despite these efforts, you still periodically wake up after drinking with feelings of anxiety, practice mindfulness. Pay attention to how you feel while you’re drinking and afterward. And when anxious feelings surface, turn to healthy alternatives like meditation, deep breathing or exercise.

Want more wellness advice? Subscribe to get the latest tips.To find a doctor or therapist at Henry Ford, visit henryford.com or call 1-800-HENRYFORD (436-7936).

Dr. Elizabeth Bulat is the medical director of addiction medicine at Henry Ford’s Maplegrove Center in West Bloomfield.

A health and wellness blog produced by Henry Ford Health System, and designed to share our knowledge on a variety of topics – from tips on eating healthy, staying fit and reducing stress to advice on chronic disease management and news on medical research and health technology.